-----------------------Вопрос 1-----------------------

A 76-year-old patient with transmural myocardial infarction is suspected

Правильный ответ:
Emergency operation
Ответ:
Observation and surgery when symptoms of peritonitis appear
Ответ:
Prescribing massive doses of broad-spectrum antibiotics and surgery
Ответ:
Operation when confirming the diagnosis by laparoscopy

-----------------------Вопрос 2-----------------------
2. At an outpatient appointment, you suspected a patient has acute appendicitis.
What is advisable to take?

Правильный ответ:
Immediately hospitalize the patient
Ответ:
Prescribe antispasmodics and re-examine the patient after 4-6 hours
Ответ:
Monitor the dynamics of body temperature within 12-24 hours and
the number of leukocytes in the blood

Ответ:
. Prescribe anti-inflammatory therapy and examine the patient for
the next day

-----------------------Вопрос 3-----------------------
3. Acute catarrhal appendicitis is manifested by the following clinical
signs: 1. Symptom Kocher-Volkovich
2. Symptom Bartomier-Michelson
3. Increased body temperature
4. Rovzing's symptom
5. Symptom Shchetkin-Blumberg
Choose the correct combination of answers:

Ответ:
1, 2, 5
Ответ:
2, 3, 5
Ответ:
1, 4, 5
Правильный ответ:
1, 2, 3, 4

-----------------------Вопрос 4-----------------------
Which of the following conditions is an indication for tamponade?abdominal cavity with acute appendicitis?
Obese grade III
3.Gangrenous appendicitis
4 periappendicular abscess
5. Local peritonitis
Indicate the correct combinations of answers

Ответ:
1, 2, 4
Ответ:
2, 3, 4
Ответ:
3, 4, 5
Правильный ответ:
1 and 4

-----------------------Вопрос 5-----------------------
. Operation "appendectomy" in acute appendicitis is contraindicated:
Правильный ответ:
1. With appendicular infiltrate
Ответ:
2. Acute myocardial infarction
Ответ:
Pregnancy 36-40 weeks
Ответ:
Intolerance to novocaine

-----------------------Вопрос 6-----------------------
For differential diagnosis of acute appendicitis from
right-sided renal colic, you will take:
1.Introduction of antispasmodics
2.Introduction of narcotic pain relievers
3. Urgent urine test
4.Chromocystoscopy or excretory urography
5.Angiography of the renal arteries
Choose the correct combination of answers:

Ответ:
1, 3, 5
Ответ:
2, 3, 4
Ответ:
3, 4, 5
Правильный ответ:
1, 3, 4

-----------------------Вопрос 7-----------------------
Perforated appendicitis is characterized by the following symptoms1.Presence of free gas in the abdominal cavity
2.Reduction of circulating blood volume
3 sudden increase in abdominal pain
4. Tension of the muscles of the anterior abdominal wall
5.Positive symptom of Shchetkin-Blumberg
Please enter the correct combination of answers:

Ответ:
1, 3, 4
Ответ:
2, 4, 5
Правильный ответ:
3, 4, 5
Ответ:
1, 4, 5

-----------------------Вопрос 8-----------------------
Primary gangrenous appendicitis develops due to:
Ответ:
Thrombosis of the inferior mesenteric vein
Ответ:
Stenosis of the orifice of the iliocolic artery
Ответ:
Nonspecific arteritis of the visceral branches of the aorta
Правильный ответ:
Thrombosis of the artery of the appendix

-----------------------Вопрос 9-----------------------
In acute phlegmonous appendicitis, a symptom is observed:
1.Schetkin-Blumberg
2.Bartomier-Michelson
3.Kocher-Volkovich
4.Rovzing
5 Murphy
Choose the correct combination of answers:

Ответ:
1, 2, 4, 5
Правильный ответ:
1, 2, 3, 4
Ответ:
2, 3, 5
Ответ:
3, 4, 5

-----------------------Вопрос 10-----------------------
What special methods need to be applied when differentiating
acute appendicitis with a covered perforated duodenal ulcer?
1.Gastroduodenoscopy
2.General fluoroscopy of the abdominal cavity
3.Ultrasonography of the abdominal cavity
4.Laparoscopy
5.Rantgenography of the stomach with barium sulfate
Choose the correct combination of answers:

Ответ:
1, 2, 3
Ответ:
2, 3, 5
Правильный ответ:
1, 2, 4
Ответ:
Only 2 and 4

-----------------------Вопрос 11-----------------------
Which of the symptoms of acute appendicitis is rare in humans
old age?

Ответ:
Minor pain in the right iliac region
Правильный ответ:
High body temperature
Ответ:
Muscle tension in the right iliac region
Ответ:
Stool retention

-----------------------Вопрос 12-----------------------
Which of the following studies is the least informative in
diagnosis of acute appendicitis?

Ответ:
Laboratory research / especially - the number of blood leukocytes
Правильный ответ:
. Laparocentesis
Ответ:
Rectal examination
Ответ:
Axillary and rectal thermometry

-----------------------Вопрос 13-----------------------
Clinical features of acute appendicitis in elderly patients
is an:
1.The possibility of development of the primary gangrenous form
2.Mild pain syndrome
3 indomitable vomiting
4.Hectic temperature
5.Mild symptoms of peritoneal irritation
Choose the correct combination of answers:

Ответ:
1, 2, 4
Ответ:
2, 3, 4
Правильный ответ:
1, 2, 5
Ответ:
1, 3, 5

-----------------------Вопрос 14-----------------------
. To distinguish acute appendicitis from ovarian apoplexy, it is necessary
consider the following clinical signs:
1. Symptom Kocher-Volkovich
2. A symptom of Promptov
3. Dizziness or fainting
4. Symptom Bartomier-Michelson
eight
5. Irradiation of pain in the sacrum and perineum
6. Kulenkampf's symptom
Choose the correct combination of answers:

Ответ:
1, 2, 4, 6
Ответ:
2, 3, 6, 5
Ответ:
I and 4
Правильный ответ:
All these signs

-----------------------Вопрос 15-----------------------
. A patient, 23 years old, with a pregnancy of 32 weeks, is in
surgical department 18 hours, with dynamic observation completely
it is impossible to exclude the presence of acute appendicitis. What is your treatment strategy?

Правильный ответ:
The patient needs to be operated on
Ответ:
It is necessary to continue monitoring the patient
Ответ:
Perform abdominal ultrasonography
Ответ:
Together with a gynecologist, induce an artificial termination of pregnancy,

-----------------------Вопрос 16-----------------------
You should operate on a patient with a typical picture of acute
phlegmonous appendicitis. What kind of prompt access is advisable
to make an appendectomy in this case?

Ответ:
Lower midline laparotomy
Правильный ответ:
Volkovich-Dyakonov section
Ответ:
Right-sided pararectal access
Ответ:
Right-sided transrectal incision

-----------------------Вопрос 17-----------------------
In what case of acute appendicitis the patient is shown a general
anesthesia?

Ответ:
A patient with early pregnancy
Правильный ответ:
. In case of complication of acute appendicitis by diffuse peritonitis
Ответ:
Patients from 14 to 16 years old
Ответ:
If you suspect a retrocecal arrangement of the appendix

-----------------------Вопрос 18-----------------------
Surgery for acute appendicitis is contraindicated in
case:

Правильный ответ:
Formation of appendicular infiltrate
Ответ:
Pregnancy 36-38 weeks
Ответ:
Decompensated heart disease
Ответ:
Acute myocardial infarction

-----------------------Вопрос 19-----------------------
What measures are necessary for suspected acute appendicitis?
Ответ:
Appointment of cold locally, painkillers and antispasmodics with
dynamic observation

Ответ:
Operation appendectomy
Ответ:
Operation appendectomy with drainage of the abdominal cavity
Правильный ответ:
Dynamic observation for 4-6 hours with temperature control
body and the number of leukocytes in the blood

-----------------------Вопрос 20-----------------------
Acute appendicitis is not characterized by a symptom
Ответ:
Rovzinga
Ответ:
Voskresensky
Правильный ответ:
Murphy
Ответ:
Obraztsova

-----------------------Вопрос 21-----------------------
. The symptom is specific for acute appendicitis
Ответ:
Kocher-Volkovich
Ответ:
Rovzing
Ответ:
Sitkovsky
Правильный ответ:
None of them

-----------------------Вопрос 22-----------------------
Peritoneal symptoms in acute appendicitis include
symptoms:
Ответ:
Voskresensky (shirt syndrome)
Ответ:
Shchetkin-Blumberg
Ответ:
Razdolsky
Правильный ответ:
All named symptoms

-----------------------Вопрос 23-----------------------
. Acute appendicitis should be differentiated from all of the above
diseases, except for:

Правильный ответ:
Glomerulonephritis
Ответ:
Acute pancreatitis
Ответ:
Acute adnexitis
Ответ:
Acute gastroenteritis

-----------------------Вопрос 24-----------------------
Clinically acute appendicitis can be accepted:
Ответ:
For salpingitis
Ответ:
For acute cholecystitis
Ответ:
For Meckel's diverticulitis
Правильный ответ:
For any of these types of pathology

-----------------------Вопрос 25-----------------------
It is not true for acute appendicitis that:

Ответ:
Stiffness of the abdominal wall may be absent with retrocecal
the location of the appendix

Ответ:
Rigidity may not be in the pelvic position
Правильный ответ:
Vomiting always precedes pain
Ответ:
Pain may begin in the navel

-----------------------Вопрос 26-----------------------
Primary gangrenous appendicitis most often occurs
Ответ:
In children
Ответ:
In severely injured persons
Ответ:
In men ten

Правильный ответ:
In the elderly and senile age

-----------------------Вопрос 27-----------------------
Acute appendicitis in children differs from that in adults in all
except:
Ответ:
Cramping nature of pain, diarrhea, repeated vomiting
Ответ:
Rapid development of diffuse peritonitis
Ответ:
High temperature
Правильный ответ:
Sharp muscle tension in the right iliac region

-----------------------Вопрос 28-----------------------
During surgery for acute appendicitis in the elderly
it is advisable to use:

Ответ:
Endotracheal anesthesia
Ответ:
Intravenous anesthesia
Правильный ответ:
Local anesthesia
Ответ:
Peridural anesthesia

-----------------------Вопрос 29-----------------------
Perforated appendicitis is characterized by:
Ответ:
Razdolsky's symptom
Ответ:
An increase in the clinical picture of peritonitis
Ответ:
Sudden increase in abdominal pain
Правильный ответ:
All of the above

-----------------------Вопрос 30-----------------------
Decisive in the differential diagnosis of acute appendicitis with
a disturbed ectopic pregnancy is:

Ответ:
Symptom Kocher-Volkovich
Ответ:
A symptom of Promptov
Ответ:
Dizziness and fainting
Правильный ответ:
Puncture of the posterior fornix of the vagina

-----------------------Вопрос 31-----------------------
Do not use for the diagnosis of acute appendicitis:
Ответ:
Palpation of the abdominal wall
Ответ:
Clinical blood test
Ответ:
Digital rectal examination
Правильный ответ:
Irrigoscopy

-----------------------Вопрос 32-----------------------
Contraindications for emergency appendectomy are:
Правильный ответ:
Appendicular infiltration
Ответ:
Myocardial infarction
Ответ:
The second half of pregnancy
Ответ:
Hemorrhagic diathesis

-----------------------Вопрос 33-----------------------
With diffuse purulent peritonitis of appendicular origin
apply:

Ответ:
Midline laparotomy
Ответ:
Appendectomy
eleven

Ответ:
Washing of the abdominal cavity
Правильный ответ:
All of the above

-----------------------Вопрос 34-----------------------
For the diagnosis of acute appendicitis, the following methods are used:
Ответ:
Laparoscopy
Ответ:
Clinical blood test
Ответ:
Rectal examination
Правильный ответ:
All of the above is true

-----------------------Вопрос 35-----------------------
. For differential diagnosis between the lower lobe
right-sided pneumonia and acute appendicitis should be considered everything except:

Ответ:
Data auscultation of the respiratory system
Ответ:
Data from laparoscopy
Ответ:
Data of fluoroscopy of the chest
Правильный ответ:
The number of blood leukocytes

-----------------------Вопрос 36-----------------------
With diffuse purulent peritonitis of appendicular origin
showing:

Ответ:
Appendectomy and debridement of the abdominal cavity
Ответ:
Correction of water-electrolyte disturbances
Ответ:
Antibiotic therapy
Правильный ответ:
All of the above is true

-----------------------Вопрос 37-----------------------
. For the late stage of peritonitis of appendicular origin
everything is typical except

Ответ:
Distension of the abdomen
Ответ:
Dehydration
Ответ:
Disappearance of intestinal murmurs
Правильный ответ:
Enhanced peristalsis

-----------------------Вопрос 38-----------------------
The most rational method of processing the stump of the appendix in
adults is:

Ответ:
Bandaging with a silk ligature with immersion of the stump
Ответ:
Bandaging with lavsan ligature with immersion of the stump
Ответ:
Immersion of the unbound stump
Правильный ответ:
Bandaging with a catgut ligature with immersion of the stump

-----------------------Вопрос 39-----------------------
The development of the pathological process in acute appendicitis begins:
Ответ:
From the serous cover of the appendix
Правильный ответ:
From the mucous membrane of the appendix
Ответ:
From the muscle layer of the appendix
Ответ:
From the mucous membrane of the dome of the cecum

-----------------------Вопрос 40-----------------------
Meckel's diverticulum arises:
1. On the jejunum
12
2. On the ileum
3. On the ascending colon
4. As a consequence of appendectomy
5. Due to non-closure of the vitelline duct
The correct one would be:

Ответ:
1.5
Ответ:
2, 4
Правильный ответ:
2.5
Ответ:
3, 4

-----------------------Вопрос 41-----------------------
What research method is the most informative in differential
diagnosis of acute appendicitis and impaired ectopic pregnancy?

Ответ:
. Study of leukocytosis in peripheral blood
Ответ:
Skin thermometry
Ответ:
Plain radiography of the abdominal organs
Правильный ответ:
Puncture of the posterior fornix of the vagina

-----------------------Вопрос 42-----------------------
. What are the fundamental differences between surgical interventions
with catarrhal and phlegmonous forms of acute appendicitis?

Правильный ответ:
The need for revision of the abdominal organs before performing
appendectomy for catarrhal appendicitis

Ответ:
The need for novocaine blockade of the mesentery of the appendix
with phlegmonous appendicitis

Ответ:
The obligatory introduction of drainage into the abdominal cavity with phlegmonosen
appendicitis

Ответ:
. The need for revision of the abdominal organs after removal
appendix with catarrhal appendicitis

-----------------------Вопрос 43-----------------------
. When examining a patient, 76 years old, at home, the local therapist suspected
acute appendicitis, but there is no complete certainty of the diagnosis. Since the beginning
the disease took only six hours. What should I do?

Ответ:
. Recommend a consultation with a surgeon
Ответ:
Urgently send the patient to the clinic for additional laboratory
survey

Ответ:
Given the age of the patient and the short period from the onset of the disease,
recommend conservative treatment. Rest, local cold, antibiotics

Правильный ответ:
Urgently hospitalize the patient in a surgical hospital

-----------------------Вопрос 44-----------------------
. As you know, the Kocher-Volkovich symptom is one of the most
informative symptoms in the diagnosis of acute appendicitis. Indicate if
what disease can there be a similar movement of pain:

Ответ:
Acute pyelonephritis
Ответ:
Crohn's disease
Ответ:
Acute right-sided adnexitis
Правильный ответ:
Perforated stomach or duodenal ulcer

-----------------------Вопрос 45-----------------------
. Specify the signs that are not typical for the clinical picture of acute
appendicitis in elderly and senile patients:
1. Abdominal pain does not differ in intensity and often has non-localized
character
2. Expressed muscle protection and symptoms of irritation of the peritoneum
3. The disease often proceeds against the background of stool retention
4. As a rule, there is a high leukocytosis and hyperthermia.
5. Appendicular infiltration often develops
Choose the correct combination of answers:

Правильный ответ:
2, 4
Ответ:
1.2
Ответ:
4, 5
Ответ:
3, 4

-----------------------Вопрос 46-----------------------
Patient, 76 years old, with transmural myocardial infarction
phlegmonous appendicitis was diagnosed. Your actions?

Правильный ответ:
Emergency operation
Ответ:
Observation and surgery when symptoms of peritonitis appear
Ответ:
Prescribing massive doses of antibiotics and surgery if ineffective
antibiotic therapy

Ответ:
Perform laparoscopy, if the diagnosis is confirmed - surgery

-----------------------Вопрос 47-----------------------
Acute catarrhal appendicitis is manifested by the following
clinical signs:
1. Symptom Kocher-Volkovich
2. Symptom Bartomier-Michelson
3. Increased body temperature
4. Rovzing's symptom
5. Symptom of Shchetkin-Blumberg
Choose the correct combination of answers:

Ответ:
1.2.5
Ответ:
2,3,5
Ответ:
1.4.5
Правильный ответ:
1,2,3,4

-----------------------Вопрос 48-----------------------
What are the symptoms characteristic of the gangrenous form of acute
appendicitis?
1. "Board-shaped" belly
2. Sudden increase in pain in the right iliac region
3.Reduction of pain sensations
4.Tachycardia
5.Positive symptom of Shchetkin-Blumberg
in the right iliac region
Indicate the correct combination of the answer:

Ответ:
1,2, 5
Правильный ответ:
3, 4, 5
Ответ:
1.4, 5
Ответ:
2 and 3

-----------------------Вопрос 49-----------------------
. The introduction of tampons into the right iliac fossa after appendectomy
shown at:
1.Periappendicular abscess
2.Gangrene of the appendix
3.Retrocecal location of the appendix
4.Capillary bleeding from tissues in the area of the vermiform
scion
5.peritonitis
Choose the correct combination of answers:

Правильный ответ:
1.4
Ответ:
3, 5
Ответ:
4, 5
Ответ:
1,2,3

-----------------------Вопрос 50-----------------------
The Kocher-Volkovich symptom is:
Ответ:
Increased pain in the right iliac region when pushing in the left
iliac region

Ответ:
Increased pain in the right iliac region with tension in the right
iliopsoas muscle

Ответ:
Increased pain in the right iliac region in the position of the patient on the left
sideways

Правильный ответ:
Moving pain from the epigastric region or upper half
abdomen to the iliac region

-----------------------Вопрос 51-----------------------
A patient, 23 years old, with a pregnancy of 32 weeks, is in
surgical department 18 hours, with dynamic observation it is impossible
completely exclude acute appendicitis. What is your treatment strategy?

Ответ:
The patient needs to be operated on
Ответ:
Continue monitoring the patient
Ответ:
Perform abdominal ultrasonography
Правильный ответ:
Perform laparoscopy and, if the diagnosis is confirmed, operate

-----------------------Вопрос 52-----------------------
The main symptom that allows you to diagnose the pelvic location
acute appendicitis:

Ответ:
Symptom Shchetkin-Blumberg
Ответ:
Rovzing's symptom
Правильный ответ:
. Soreness of the anterior wall of the rectum with rectal
research

Ответ:
Muscle tension in the right iliac region

-----------------------Вопрос 53-----------------------
The diagnostic program for acute appendicitis includes:
1. Careful collection of anamnestic data
2. Excludes somatic diseases that can simulate acute
abdominal pathology
3. Rectal examination in men and additional vaginal examination
15
among women
4. Conducting laboratory research
5. Possible emergency chromocystoscopy
Choose the correct combination of answers:

Ответ:
1.2, 3.4
Ответ:
1,2,3
Правильный ответ:
all answers are correct
Ответ:
1.3, 4, 5

-----------------------Вопрос 54-----------------------
Primary gangrenous appendicitis develops due to:
Ответ:
Massive adhesions in the abdominal cavity
Ответ:
Retrocecal location of the appendix
Ответ:
. Violations of the rheological properties of blood
Правильный ответ:
Thrombosis of the artery of the appendix

-----------------------Вопрос 55-----------------------
. For the differential diagnosis of acute appendicitis and acute
calculous cholecystitis should be used:
1. Clinical blood test
2. Plain fluoroscopy of the abdominal cavity
3. Ultrasonic research method
4. Oral cholecystography
5. Laparoscopy
Choose the correct combination of answers:

Ответ:
1.3, 4
Ответ:
2, 3, 4
Правильный ответ:
3, 5
Ответ:
4, 5

-----------------------Вопрос 56-----------------------
What special research methods need to be applied when
differential diagnosis of acute appendicitis with a covered perforated ulcer
12 duodenal ulcer?
1. Gastroduodenoscopy
2. Plain fluoroscopy of the abdominal cavity
3. Ultrasonography of the abdominal cavity
4. Laparoscopy
5. Irrigoscopy
Choose the correct combination of answers:

Ответ:
1,2,3
Ответ:
2, 3, 5
Правильный ответ:
1,2,4
Ответ:
2.4

-----------------------Вопрос 57-----------------------
. In acute appendicitis, symptoms are revealed:
1. Volkovich-Kocher
2. Rovzing
3. Mayo-Robson
4. Sitkovsky
5. Bartomier-Michelson
16
Choose the correct combination of answers

Ответ:
1,2,3,4
Ответ:
1.3.5
Правильный ответ:
1,2,4,5
Ответ:
2,3,4,5

-----------------------Вопрос 58-----------------------
In what case of acute appendicitis the patient is shown a general
anesthesia?

Ответ:
A patient with early pregnancy
Правильный ответ:
In case of complication of acute appendicitis by diffuse peritonitis
Ответ:
Patients from 14 to 16 years old
Ответ:
If you suspect a retrocecal arrangement of the appendix

-----------------------Вопрос 59-----------------------
In a patient operated on for acute phlegmonous appendicitis
and diffuse peritonitis by access in the right iliac region, on the 20th day
after the operation, a right-sided subphrenic abscess was diagnosed. What
could have caused its formation?
1. The patient after the operation was not given the Trendelenburg position
2. The patient after the operation was not given the Fowler position
3. The wrong approach was chosen;
laparotomy
4. Abdominal effusion has not been drained
5. Abdominal tamponade was not performed
Choose the correct combination of answers:

Ответ:
1.3, 5
Ответ:
1 and 4
Ответ:
1 and 5
Правильный ответ:
2, 3, 4

-----------------------Вопрос 60-----------------------
Which of the following methods are not used for recognition
abdominal abscesses?
1. Ultrasound scanning
2. Plain radiography of the abdominal cavity
3. Colonoscopy
4. Computed tomography
5. Laparoscopy.
Choose the correct combination of answers

Ответ:
1.3, 5
Ответ:
2, 4
Правильный ответ:
3, 5
Ответ:
2, 4, 5

-----------------------Вопрос 61-----------------------
Patient, 76 years old, with transmural myocardial infarction
17
phlegmonous appendicitis was diagnosed. Your actions?

Правильный ответ:
Emergency operation
Ответ:
Observation and surgery when symptoms of peritonitis appear
Ответ:
Prescribing massive doses of antibiotics and surgery if ineffective
antibiotic therapy

Ответ:
Perform laparoscopy, if the diagnosis is confirmed - surgery

-----------------------Вопрос 62-----------------------
Pylephlebitis is usually a complication of:
Ответ:
Perforated stomach ulcer
Ответ:
Volvulus of the small intestine
Ответ:
Infarction of the small intestine due to embolism of the superior mesenteric artery
Правильный ответ:
Destructive appendicitis

-----------------------Вопрос 63-----------------------
Appendicular infiltration usually develops:
Ответ:
In the first two days from the moment of illness
Правильный ответ:
3-4 days from the moment of illness
Ответ:
On the 7-9th day from the moment of illness
Ответ:
. In the early period after appendectomy

-----------------------Вопрос 64-----------------------
. Insertion of tampons into the right iliac fossa after appendectomy
shown at:
1. Periappendicular abscess
2. Gangrene of the appendix
3. Retrocecal arrangement of the appendix
4.Capillary bleeding from tissues in the area of the vermiform
scion
5.peritonitis
Choose the correct combination of answers

Правильный ответ:
1.4
Ответ:
3, 5
Ответ:
4, 5
Ответ:
1,2,3

-----------------------Вопрос 65-----------------------
In case of complication of acute appendicitis by appendicular infiltrate
conservative treatment is indicated because:
1. Self-healing is possible
2. Resorption of the infiltrate is possible
3. When trying to make an appendectomy, perforation of the small intestine is possible
4. After resorption of the infiltrate, a mild form of the disease develops -
chronic appendicitis
5. When trying to isolate the appendix from the infiltrate, it can
develop peritonitis
Indicate the correct combination of answers:

Ответ:
1.3
Ответ:
2, 4
Правильный ответ:
All answers are correct
Ответ:
3 and 5
eighteen

-----------------------Вопрос 66-----------------------
. When differentiating a subphrenic abscess from a right-sided
lower lobe pneumonia are the most important signs in terms of staging
the diagnosis will be:
1. Restriction of the mobility of the right dome of the diaphragm during fluoroscopy
chest
2. Presence of suprahepatic fluid level on plain radiography
abdominal cavity
3. Obtaining pus during puncture of the pleural cavity
4. Obtaining pus during puncture of the subphrenic space
5. Fluoroscopic picture: darkening of the lower lobe of the right lung
Choose the correct combination of the answer:

Ответ:
1.3, 5
Правильный ответ:
1,2,4
Ответ:
1,2, 5
Ответ:
2, 3, 4

-----------------------Вопрос 67-----------------------
You suspect the patient has an abscess of the Douglas space. What kind
research needs to be done to diagnose it?
1. Sigmoidoscopy
2. Digital examination of the rectum
3. Ultrasonography
4. Laparoscopy
5. Plain fluoroscopy of the abdominal cavity
Choose the correct combination of the answer:

Ответ:
1.3, 5
Ответ:
2, 4, 5
Правильный ответ:
2, 3
Ответ:
3, 4

-----------------------Вопрос 68-----------------------
A patient, 23 years old, with a pregnancy of 32 weeks, is in
surgical department 18 hours, with dynamic observation it is impossible
completely exclude acute appendicitis. What is your treatment strategy?

Правильный ответ:
. The patient needs to be operated on
Ответ:
Continue monitoring the patient
Ответ:
Perform abdominal ultrasonography
Ответ:
Together with the gynecologist, cause an artificial termination of pregnancy, and
then have an appendectomy

-----------------------Вопрос 69-----------------------
Abscess of the Douglas space after appendectomy is characterized by
the following main features:
1. Hectic temperature
2. Pain in the depth of the pelvis and tenesmus
3. Restricted diaphragm mobility
4. Overhanging the walls of the vagina or the anterior rectal wall
5. Tension of the muscles of the anterior abdominal wall
Give the correct combination of answers:

Ответ:
1.3, 5
Правильный ответ:
1,2,4
Ответ:
1.3.4
Ответ:
2.3.4

-----------------------Вопрос 70-----------------------
Emergency appendectomy is not indicated for:
Ответ:
Acute catarrhal appendicitis
Ответ:
Acute appendicitis in the second half of pregnancy
Ответ:
The first attack of acute appendicitis
Правильный ответ:
Unclear diagnosis of acute appendicitis in elderly patients

-----------------------Вопрос 71-----------------------
Symptoms of appendicular infiltrate are all except:
Ответ:
Subfebrile temperature
Ответ:
Duration of the disease 4-5 days
Правильный ответ:
Profuse diarrhea
Ответ:
. Increase in the number of blood leukocytes

-----------------------Вопрос 72-----------------------
In a patient who underwent appendectomy, starting from 5 days on the background
decrease in local pain, there was a deterioration in the general condition:
an increase in temperature, its hectic ranges, an increase in the amount
leukocytes. Moderate pain appeared in the depth of the pelvis, transient dysuric
phenomena, tenesmus. What additional research method will you start with for
identify the cause of the above picture?

Ответ:
Chromocystoscopy
Ответ:
Repeated blood and urine tests
Правильный ответ:
Digital rectal examination
Ответ:
Sigmoidoscopy

-----------------------Вопрос 73-----------------------
The cause of wound suppuration after an appendectomy operation is:
Ответ:
Fecal fistula
Правильный ответ:
. Infection of the wound during the operation
Ответ:
Actinomycosis
Ответ:
Cancer of the cecum

-----------------------Вопрос 74-----------------------
Tamponade of the abdominal cavity after appendectomy for acute
appendicitis is not indicated for:

Ответ:
Unstoppable capillary bleeding
Ответ:
Uncertainty about the complete removal of fecal stones that fell out at the time
ruptured appendix surgery

Правильный ответ:
Presence of turbid effusion in the right iliac region
Ответ:
Uncertainty in adequate immersion of the stump of the appendix

-----------------------Вопрос 75-----------------------
What symptoms are characteristic of the gangrenous form of acute
appendicitis?
1. "Board-shaped" belly
2. Sudden increase in pain in the right iliac region
3. Reducing pain
twenty
4. Tachycardia
5. Symptom Shchetkin-Blumberg in the right iliac region
Choose the correct combination of answers:

Ответ:
1, 2, 5
Правильный ответ:
3, 4, 5
Ответ:
1, 4, 5
Ответ:
2, 3

-----------------------Вопрос 76-----------------------
Insertion of tampons into the right iliac fossa after appendectomy
shown at:
1. Gangrene of the appendix
2. Retrocecal arrangement of the appendix
3. Capillary bleeding from tissues in the area of the vermiform
scion
4. Suspicion of a detachment of the apex of the appendix during its retrograde removal
5. In case of loss of fecal stones during the release of the appendix
Choose the correct combination of answers:

Ответ:
1, 2, 3
Ответ:
2, 3, 4
Правильный ответ:
3, 4, 5
Ответ:
l, 4, 5

-----------------------Вопрос 77-----------------------
In the differential diagnosis of subphrenic abscess with
right-sided lower lobe pneumonia the most important signs
abscess are:
1. Restriction of mobility of the right dome of the diaphragm during fluoroscopy
chest
2. Presence of suprahepatic fluid level on plain radiography
abdominal cavity
3. Obtaining pus during puncture of the pleural cavity
4. Obtaining pus during puncture of the subphrenic space
5. Darkening of the lower lobe of the right lung during chest fluoroscopy
Choose the correct combination of answers:

Ответ:
1, 3, 4
Правильный ответ:
1, 2, 4
Ответ:
1, 2, 5
Ответ:
2, 3, 4

-----------------------Вопрос 78-----------------------
The development of pylephlebitis is most likely with one of the following forms
acute appendicitis

Ответ:
Appendicular colic
Правильный ответ:
Primary gangrenous appendicitis
Ответ:
Phlegmonous appendicitis
Ответ:
Phlegmonous appendicitis, proceeding with inflammation of the mesentery
appendix

-----------------------Вопрос 79-----------------------
What method will you choose to diagnose Douglas abscess
space?

Ответ:
Sigmoidoscopy
Ответ:
Laparoscopy
Ответ:
Percussion and auscultation of the abdomen
Правильный ответ:
Digital rectal examination

-----------------------Вопрос 80-----------------------
For differential diagnosis between acute appendicitis and
with right-sided renal colic, you will do:
1. Introduction of antispasmodics
2. Drug injection
3. Urgent urine examination
4. Chromocystoscopy
5. Angiography of the renal arteries
Choose the correct combination of answers:

Ответ:
1.3, 5
Ответ:
2, 3.4
Ответ:
3.4.5
Правильный ответ:
1.3.4

-----------------------Вопрос 81-----------------------
. Perforated appendicitis is characterized by the following symptoms:
1. The presence of free gas in the abdominal cavity
2. Decrease in the volume of circulating red blood cells
3. Sudden increase in abdominal pain
4. Tension of the muscles of the anterior abdominal wall
5. Positive symptom of Shchetkin-Blumberg
Choose the correct combination of answers:

Ответ:
1,2,3
Ответ:
2, 4, 5
Правильный ответ:
3, 4.5
Ответ:
1.4.5

-----------------------Вопрос 82-----------------------
A patient, 18 years old, on the 7th day after the operation of appendectomy developed
pelvic abscess. What will you do?

Ответ:
Massive antibiotic therapy
Ответ:
Open the abscess with the lower midline approach and drain the small pelvis
Ответ:
. Open the abscess through the right iliac region
Правильный ответ:
Drain the abscess through the anterior rectal wall

-----------------------Вопрос 83-----------------------
. In a patient, 40 years old, on the 2nd day after the operation of appendectomy,
produced for gangrenous appendicitis, intestinal paresis developed,
chills, pains in the right side of the abdomen began to disturb, the liver increased and
jaundice appeared. There were no symptoms of peritoneal irritation. About development
what complication of acute appendicitis in the first place can you think?

Ответ:
Peritonitis
Ответ:
Subphrenic abscess
Ответ:
Interintestinal abscess
Правильный ответ:
Pylephlebitis
-----------------------Вопрос 84-----------------------
Phlegmon of the retroperitoneal space, as a complication of acute
appendicitis, develops when:

Ответ:
. Anterior subhepatic location of the appendix
Ответ:
. Local peritonitis in the right iliac region
Правильный ответ:
Retroperitoneal location of the appendix
Ответ:
Medial location of the appendix

-----------------------Вопрос 85-----------------------
Lancing of the subphrenic abscess is performed by the following access:1. Thoracolaparotomy
2. Lumbotomy
3. Two-stage transepleural access
4. Laparotomy in the right hypochondrium according to Fedorov
5. Extrapleural extraperitoneal method
Choose the correct combination of answers:

Ответ:
1,2,3
Ответ:
1.4.5
Ответ:
2, 3, 5
Правильный ответ:
3, 4, 5

-----------------------Вопрос 86-----------------------
During an operation for acute appendicitis, a patient was diagnosed with
appendicular infiltration. What tactical decision needs to be made?

Ответ:
Make a diagnostic puncture of the infiltrate
Правильный ответ:
Refuse further manipulations and sew up the operating wound
tightly

Ответ:
Limit inflammatory infiltration with gauze swabs
Ответ:
Drain the abdominal cavity

-----------------------Вопрос 87-----------------------
In the treatment of diffuse peritonitis of appendicular origin
the main importance is:

Ответ:
Elimination of the source of peritonitis
Правильный ответ:
All answers are correct
Ответ:
Correction of water-electrolyte disturbances
Ответ:
Sanitation of the abdominal cavity

-----------------------Вопрос 88-----------------------
Typical complications of acute appendicitis are:
1. Appendicular infiltration
2. Abscess of the omental bursa
3. Pylephlebitis
4. Abscess of Douglas space
5. Pyelonephritis
The correct ones will be:

Ответ:
1,2,3
Правильный ответ:
1.3.4
Ответ:
2, 4, 5
Ответ:
1.2.4

-----------------------Вопрос 89-----------------------
Both before and after appendectomy development is possible:
23
1. Appendicular infiltration
2. Spilled peritonitis
3. Periappendicular abscess
4. Local abscess of the abdominal cavity
5. Retroperitoneal phlegmon
The correct ones will be:

Ответ:
1,2,3,4
Ответ:
1.3.5
Правильный ответ:
2.4.5
Ответ:
3.4.5

-----------------------Вопрос 90-----------------------
Perforation of the appendix is manifested:
1. Sharp pain in the right iliac region, especially noticeable against the background
imaginary subsiding of pain during the development of gangrene
2. By tension of the abdominal wall, first in the right iliac region, and then
spreading to other departments
3. Increasing bloating
4. Leukocytosis
5. Decrease in body temperature
The correct one would be:

Правильный ответ:
1,2,3,4
Ответ:
2,3,4,5
Ответ:
1,2,3,5
Ответ:
1,3,4,5

-----------------------Вопрос 91-----------------------
In acute appendicitis and perforated ulcer, symptoms may occur:
1. Volkovich-Kocher
2. Speciary
3. Shchetkin-Blumberg
4. Voskresensky ("shirt" symptom)
5. Krymova
The correct one would be:

Правильный ответ:
1,2,3,4
Ответ:
1,2,4,5
Ответ:
1,2,3,5
Ответ:
1,3,4,5

-----------------------Вопрос 92-----------------------
Differential diagnosis of acute appendicitis and perforated ulcer
help:
1. Carefully collected and correctly interpreted the nearest and
distant history
2. Plain X-ray of the abdominal cavity
3. Selective celiacography
4. Laparoscopy
5. Laparocentesis using a "groping" catheter
The correct one would be:

Ответ:
1,2,3,4
Правильный ответ:
1,2,4,5
Ответ:
1,2,3,5
Ответ:
2,3,4,5

-----------------------Вопрос 93-----------------------
And with acute appendicitis and acute pancreatitis may occur
general symptoms:
1. Sudden onset of the disease
2. Localization of pain in the epigastric region
3. Girdle pain
4. Localization of pain in the right iliac region
5. Repeated vomiting of bile, which does not bring relief
The correct one would be:

Ответ:
1, 2, 5
Ответ:
2, 3, 4, 5
Правильный ответ:
1, 2, 4
Ответ:
1, 2, 3, 4

-----------------------Вопрос 94-----------------------
Indications for tamponing of the abdominal cavity after appendectomy
are:
1. Inability to remove all or part of the appendix
2. Opening of the periappendicular abscess
3. Unreliable hemostasis
4. The risk of developing insolvency of the sutures, immersing the stump of the appendix
due to infiltration of the dome of the cecum
5. Retrocecal appendicitis.
The correct one would be:

Правильный ответ:
1, 2, 3, 4
Ответ:
2, 3, 4, 5
Ответ:
1, 2, 3, 4, 5
Ответ:
2, 3, 5

-----------------------Вопрос 95-----------------------
The use of tampons after appendectomy is indicated for:
1. Opening of the abscessed appendicular infiltrate
2. Phlegmonous appendicitis with profuse effusion into the abdominal cavity
3. Retrocecal appendicitis
4. Peritonitis
5. Capillary bleeding from the bed of the appendix
The correct one would be:

Ответ:
1, 2, 3, 4
Ответ:
2, 3, 4
Правильный ответ:
1, 5
Ответ:
3, 4, 5

-----------------------Вопрос 96-----------------------
For the treatment of solid pelvic infiltrates without signs
abscess formation:
1. Give an elevated position to the head end of the bed
2. Use broad-spectrum antibiotics
3. Apply warm chamomile enemas
4. Prescribe a sparing, easily digestible high-calorie diet
5. Do regular cleansing enemas
The correct one would be:

Ответ:
1, 2, 3, 4
Правильный ответ:
2, 3, 4, 5
Ответ:
1, 2, 4, 5
Ответ:
1, 2, 3, 5

-----------------------Вопрос 97-----------------------
At the present stage for the diagnosis of subphrenic abscess
can be used:
1. X-ray examination
2. Ultrasound examination
3. Selective celiacography
4. Computed tomography
5. Thermography
The correct one would be:

Ответ:
1, 2, 3, 4
Правильный ответ:
1, 2, 4, 5
Ответ:
3, 4, 5
Ответ:
2, 3, 4, 5

-----------------------Вопрос 98-----------------------
Conditions conducive to the development of the appendicular
infiltration are:
1. Untimely appeal of the patient to the doctor
2. Diagnostic errors at the prehospital and hospital stages
3. 3-5 days from the onset of the disease
4. Phlegmonous changes in the appendix
5. Perforation of the appendix
The correct one would be:

Правильный ответ:
1,2,3,4
Ответ:
1,2,4,5
Ответ:
1,2,3,5
Ответ:
1,3,4,5

-----------------------Вопрос 99-----------------------
. The initial period of formation of appendicular infiltrate
characterized by:
1. Reduction of pain in the first days of the disease
2. Improving the well-being and general condition of patients
3. Increased body temperature
4. An increase in leukocytosis and a shift of the leukocyte formula to the left
5. The appearance in the right iliac region of a dense, inactive,
slightly painful education
The correct one would be:

Ответ:
1,2,3,4
Ответ:
1,2,3,5
Ответ:
1.4.5
Правильный ответ:
1,2,3,4,5

-----------------------Вопрос 100-----------------------
For acute appendicitis complicated by appendicular
infiltrate, in contrast to a tumor of the cecum, is characterized by:
1. Short history
26
2. Acute pain in the right iliac region, accompanied by
rise in temperature
3. Symptom Volkovich-Kocher
4. Frequent phenomena of partial intestinal obstruction in the anamnesis
5. The tendency towards a decrease in tumor formation during observation
The correct one would be:

Ответ:
1.2.5
Ответ:
1,3,4,5
Правильный ответ:
1,2,3,5
Ответ:
3.4.5

-----------------------Вопрос 101-----------------------
The question of abscess formation of appendicular infiltrate may arise in
case:
1. High temperature retention, especially if it adopts hectic
character
2. Renewal or intensification of pain
3. Appearance of symptoms of peritoneal irritation
4. Increase in leukocytosis with a shift of the formula to the left, an increase in ESR
5. Absence of a tendency to decrease infiltration after 7-10 days
intensive care, especially in the context of the use of antibiotics
The correct one would be:

Ответ:
1.2
Ответ:
2.4.5
Правильный ответ:
1,2,3,4
Ответ:
2,3,4,5
-----------------------Вопрос 102-----------------------
When opening an abscessed appendicular infiltrate:
1. The operation is performed under general anesthesia.
2. If possible, extraperitoneal access is used (according to Pirogov)
3. The infiltrate is carefully divided in a blunt way, avoiding damage
infiltrated bowel loops
4. Allocated and removed destructively altered appendix
5. Thoroughly washed and drained abscess cavity
The correct one would be:

Ответ:
1,3,4,5
Ответ:
1,2,3,4,5
Правильный ответ:
1,2,3,5
Ответ:
2.4.5

-----------------------Вопрос 103-----------------------
On the sixth day after laparotomy for appendicular
peritonitis, the patient developed pain in the lower abdomen, tenesmus,
dysuric phenomena. Temperature 39.50
, on a hectic scale, chills.
The tongue is moist, the abdomen is soft, moderately painful above the pubis. At
rectal examination through the anterior rectal wall is palpated
large, painful infiltrate with softening. Diagnosis?

Ответ:
Pylephlebitis
Правильный ответ:
Abscess of the small pelvis
Ответ:
Periappendicular abscess
Ответ:
Interloop abscess

-----------------------Вопрос 104-----------------------
The most common cause of wound suppuration after appendectomy surgery:
Ответ:
Cancer of the cecum
Ответ:
Foreign body (napkin)
Ответ:
Actinomycosis
Правильный ответ:
Infection of the wound during the operation

-----------------------Вопрос 105-----------------------
. One of the following research methods allows
confirm the presence of chronic appendicitis in the patient:

Ответ:
Colonoscopy
Ответ:
Laparoscopy
Ответ:
Ultrasound of the abdomen
Правильный ответ:
Irrigoscopy

-----------------------Вопрос 106-----------------------
With what diseases should chronic
appendicitis?
1. Pathology of the right kidney
2. Chronic adnexitis
3. Chronic colitis
4. Gallstone disease
5. Helminthic invasion
Choose the correct combination of answers:
Ответ:
2, 3, 4
Правильный ответ:
With all the indicated diseases
Ответ:
2, 3, 5
Ответ:
1, 2, 4

-----------------------Вопрос 107-----------------------
. In a patient operated on for acute phlegmonous
appendicitis and local peritonitis with a typical approach, 9 days after
surgery diagnosed with a right-sided subphrenic abscess. What could
cause it to be formed?
1. The patient after the operation was not given the Trendelenburg position
2. The patient after the operation was not given the Fowler position
3. During the operation, it was necessary to use a lower midline laparotomy
access
4. Abdominal effusion has not been drained
5. Abdominal tamponade was not performed
Choose the correct combination of answers:

Ответ:
1, 4
Правильный ответ:

Правильный ответ:

Ответ:
3, 4, 5
Ответ:
1, 3, 4

-----------------------Вопрос 108-----------------------
Operating on a patient with a diagnosis of acute appendicitis. You discovered
dense appendicular infiltrate. What will you do?

Ответ:
Perform a midline laparotomy and appendectomy under general anesthesia
Правильный ответ:
Suture the wound of the abdominal wall and prescribe antibiotics and local cold
Ответ:
Isolate the appendix from the inflammatory infiltrate and
have an appendectomy

Ответ:
Limit yourself to the introduction into the abdominal cavity of a tampon and drainage

-----------------------Вопрос 109-----------------------
You have diagnosed a patient with appendicular infiltration. Complex
what conservative measures are most appropriate in the first three days?
1. Cold on the stomach
2. Appointment of antibitics
3. Locally UHF or UFO
4. Heat to the right iliac region
5. Parenteral administration of proteolytic enzymes
Indicate the correct combination of the answer:

Ответ:
2, 3
Ответ:
4, 5
Правильный ответ:
1, 2
Ответ:
1 and 5

-----------------------Вопрос 110-----------------------
The most characteristic signs of chronic appendicitis
are:
1.Symptom Voskresensky
2.Moderate blood leukocytosis
29
3.Long retention of barium suspension in the appendix,
x-ray
4. Frequent pain in the right iliac region
5 positive Sitkovsky symptom
Choose the correct combination of answers:

Ответ:
1, 2, 4
Ответ:
1 and 3
Правильный ответ:
3 and 4
Ответ:
2, 3, 4

-----------------------Вопрос 111-----------------------
The clinical signs of a subphrenic abscess are:
1. Pain in the right side of the chest and upper abdomen
2. Soreness when pressing in the area of the lower ribs
3. Hectic temperature
4. Bulging of the lower intercostal spaces
5. Expansion of the boundaries of hepatic dullness
Choose the best combination of answers:

Ответ:
3, 4, 5
Ответ:
1, 2, 3, 4
Ответ:
1, 2, 3, 5
Правильный ответ:
All answers are correct

-----------------------Вопрос 112-----------------------
A patient, 18 years old, on the 7th day after the operation of appendectomy developed
pelvic abscess. What will you do?

Правильный ответ:
Drain the abscess through the anterior rectal wall
Ответ:
Open the abscess with the lower median approach and drain the small pelvis
Ответ:
Open the abscess with access according to Volkovich-Dyakonov
Ответ:
Open the abscess by right-sided extra-abdominal access

-----------------------Вопрос 113-----------------------
In a patient operated on for gangrenous appendicitis, on the 2nd
the day after the appendectomy operation, intestinal paresis developed, increased
liver and jaundice appeared; chills and pains in the right half began to disturb
belly. There are no symptoms of peritoneal irritation. What complication of the disease
can I think?

Ответ:
Subphrenic abscess
Правильный ответ:
Pylephlebitis
Ответ:
Peritonitis
Ответ:
Interintestinal abscess

-----------------------Вопрос 114-----------------------
Phlegmon of the retroperitoneal space in acute appendicitis
develops in the case of:

Ответ:
Anterior subhepatic location of the appendix
Ответ:
Local peritonitis in the right iliac region
Ответ:
Retrocecal location of the appendix
Правильный ответ:
Retroperitoneal location of the appendix

-----------------------Вопрос 115-----------------------
. Pylephlebitis is a complication of one of the following
diseases:

Ответ:
Non-occlusive infarction of the small intestine
Ответ:
Ulcerative colitis
Правильный ответ:
Primary gangrenous appendicitis
Ответ:
Primary gangrenous cholecystitis

-----------------------Вопрос 116-----------------------
The patient is 21 years old. Operated for phlegmonous appendicitis -
performed appendectomy and drainage of the right lateral abdominal canal
cavities due to the presence of turbid effusion. After 3 days, he noted an increase in pain
throughout the abdomen, the temperature rises to 38.4 ° C. On examination, the condition
moderate, pulse rate 94 beats / min rhythmic. The tongue is dry. Painful belly
in all departments, more on the right, tense. Shchetkin's symptom is positive.
Peristalsis is sluggish. When examining the rectum, overhang and
soreness of the anterior wall. On a plain x-ray, fluid levels in
loops of the small intestine. Blood leukocytes 18200. What is your diagnosis?

Ответ:
Abscess of the vesico-rectal pocket
Ответ:
Thrombosis of mesenteric vessels
Ответ:
Acute pancreatitis
Правильный ответ:
Widespread peritonitis

-----------------------Вопрос 117-----------------------
On the 3rd day after appendectomy, based on the data of a complex
examination, you diagnosed the patient with widespread peritonitis.
What is your next tactic?

Ответ:
Strengthen antibacterial therapy
Ответ:
Prescribe antispasmodics, pain relievers
Ответ:
Conduct an angiographic study
Правильный ответ:
Perform laparotomy

-----------------------Вопрос 118-----------------------
On the 6th day after appendectomy for perforated appendicitis in
the patient has painful urination, tenesmus, loose stools. T-38.4
0C,
blood leukocytes - 16000. With a digital examination of the rectum
soreness, overhanging of the anterior rectal wall is determined. Your
diagnosis?

Ответ:
Interintestinal abscess
Правильный ответ:
Douglas pocket abscess
Ответ:
Intra-abdominal bleeding
Ответ:
Paraproctitis

-----------------------Вопрос 119-----------------------
On the 6th day after appendectomy, on the basis of examination
diagnosed with Douglas pocket abscess. Your actions?

Правильный ответ:
Open the Douglas pocket abscess through the rectum
Ответ:
Prescribe physiotherapy treatment
Ответ:
Open the paraproctitis
Ответ:
Blood transfusion

-----------------------Вопрос 120-----------------------
Appendicular infiltration usually develops:
Ответ:
For the first time two days after the disease
Правильный ответ:
3-4 days from the moment of illness
Ответ:
On the 7-9th day from the moment of illness
Ответ:
In the early period after appendectomy